Editing Triptan (section)

==Medical uses==
{| class="wikitable" style="float:right; margin:auto 1em auto 1em;"
|+ Examples of triptans
|-
| style="vertical-align:bottom" | [[File:Sumatriptan.svg|150px|class=skin-invert-image]]<br />[[sumatriptan]]
| style="vertical-align:bottom" | [[File:Rizatriptan.png|150px|class=skin-invert-image]]<br />[[rizatriptan]]
| style="vertical-align:bottom" | [[File:Naratriptan structure.png|150px|class=skin-invert-image]]<br />[[naratriptan]]
|-
| style="vertical-align:bottom" | [[File:Eletriptan_skeletal.svg|150px|class=skin-invert-image]]<br />[[eletriptan]]
| style="vertical-align:bottom" | [[File:Donitriptan.svg|150px|class=skin-invert-image]]<br />[[donitriptan]]
| style="vertical-align:bottom" | [[File:Almotriptan_skeletal.svg|150px|class=skin-invert-image]]<br />[[almotriptan]]
|-
| style="vertical-align:bottom" | [[File:Frovatriptan structure.svg|150px|class=skin-invert-image]]<br />[[frovatriptan]]
| style="vertical-align:bottom" | [[File:Avitriptan.png|150px|class=skin-invert-image]]<br />[[avitriptan]]
| style="vertical-align:bottom" | [[File:Zolmitriptan.svg|150px|class=skin-invert-image]]<br />[[zolmitriptan]]
|-
| style="vertical-align:bottom" | [[File:LY334370.svg|150px|class=skin-invert-image]]<br />[[LY-334370]]
| style="vertical-align:bottom" | [[File:L 694 247.svg|150px|class=skin-invert-image]]<br />[[L-694247]]
|
|}

===Migraine===
Triptans are used for the treatment of severe migraine attacks or those that do not respond to [[NSAID]]s<ref name="pmid17405970">{{cite journal|vauthors=Brandes JL, Kudrow D, Stark SR, etal |title=Sumatriptan-naproxen for acute treatment of migraine: a randomized trial |journal=JAMA |volume=297 |issue=13 |pages=1443–1454 |year=2007 |pmid=17405970 |doi=10.1001/jama.297.13.1443|doi-access=free }}</ref> or other [[Over-the-counter drug|over-the-counter]] drugs.<ref name="pmid11112243">{{cite journal |vauthors=Lipton RB, Baggish JS, Stewart WF, Codispoti JR, Fu M |title=Efficacy and safety of acetaminophen in the treatment of migraine: results of a randomized, double-blind, placebo-controlled, population-based study |journal=Arch. Intern. Med. |volume=160 |issue=22 |pages=3486–92 |year=2000 |pmid=11112243 |doi=10.1001/archinte.160.22.3486|doi-access=free }}</ref> Triptans are a mid-line treatment suitable for many migraineurs with typical attacks. They may not work for atypical or unusually severe migraine attacks, transformed migraine, or status migrainosus (continuous migraine).

Triptans are highly effective, reducing the symptoms or aborting the attack within 30 to 90 minutes in 70–80% of patients.<ref>{{Cite journal |last1=Sonal Sekhar |first1=M. |last2=Sasidharan |first2=Shalini |last3=Joseph |first3=Siby |last4=Kumar |first4=Anand |date=January 1, 2012 |title=Migraine management: How do the adult and paediatric migraines differ? |journal=Saudi Pharmaceutical Journal |volume=20 |issue=1 |pages=1–7 |doi=10.1016/j.jsps.2011.07.001 |issn=1319-0164 |pmc=3745030 |pmid=23960771}}</ref> A 2024 [[systematic review]] and [[Meta-analysis|network meta analysis]] compared the effectiveness of medications for acute migraine attacks in adults. It found that triptans were the most effective class of drugs followed by non-steroidal anti-inflammatories.<ref>{{Cite journal |last=Karlsson |first=William K. |last2=Ostinelli |first2=Edoardo G. |last3=Zhuang |first3=Zixuan A. |last4=Kokoti |first4=Lili |last5=Christensen |first5=Rune H. |last6=Al-Khazali |first6=Haidar M. |last7=Deligianni |first7=Christina I. |last8=Tomlinson |first8=Anneka |last9=Ashina |first9=Håkan |last10=Torre |first10=Elena Ruiz de la |last11=Diener |first11=Hans-Christoph |last12=Cipriani |first12=Andrea |last13=Ashina |first13=Messoud |date=2024-09-18 |title=Comparative effects of drug interventions for the acute management of migraine episodes in adults: systematic review and network meta-analysis |url=https://www.bmj.com/content/386/bmj-2024-080107 |journal=BMJ |language=en |volume=386 |pages=e080107 |doi=10.1136/bmj-2024-080107 |issn=1756-1833 |pmid=39293828|pmc=11409395 }}</ref><ref>{{Cite journal |date=4 April 2025 |title=Which drugs are best for migraine attacks? |url=https://evidence.nihr.ac.uk/alert/which-drugs-are-best-for-migraine-attacks/ |journal=NIHR Evidence}}</ref> 

A test measuring a person's skin [[Allodynia|sensitivity]] during a migraine may indicate whether the individual will respond to treatment with triptans.<ref>{{cite journal|year=2004|title=Defeating migraine pain with triptans: A race against the development of cutaneous allodynia|journal=Annals of Neurology|volume=55|issue=1|pages=19–26|pmid=14705108|doi=10.1002/ana.10786|last1=Burstein|first1=R|last2=Collins|first2=B|last3=Jakubowski|first3=M|s2cid=24040813}}</ref>  Triptans are most effective in those with no skin sensitivity; with skin sensitivity, it is best to take triptans within twenty minutes of the headache's onset.<ref>{{Cite journal |last2= Jakubowski|first2= Moshe|last3= Rauch|first3= Steven D.|date=2011 |title=The science of migraine |journal=Journal of Vestibular Research: Equilibrium & Orientation |volume=21 |issue=6 |pages=305–314 |doi=10.3233/VES-2012-0433 |issn=0957-4271 |pmc=3690498 |pmid=22348935|last1= Burstein|first1= Rami}}</ref>

Oral [[rizatriptan]] and nasal [[zolmitriptan]] are the most used triptans for migraines in children.<ref>{{cite journal|year=2010|title=The use of triptans for pediatric migraines|journal=Paediatr Drugs|volume=12|issue=6|pages=379–389|pmid=21028917|last1=Eiland|first1=L. S.|last2=Hunt|first2=M. O.|s2cid=11187764|doi=10.2165/11532860-000000000-00000}}</ref>

====Correct timing of intake====
Triptans should be taken as soon as possible after the onset of pain. In case of migraine with [[Aura (migraine)|aura]] they are to be taken after the aura and with the onset of pain.<ref name="AC" /> If taken too early, they may not have the full effect on symptom reduction, and in case of an aura, they can worsen the aura. It is assumed that blood vessels are [[Vasoconstriction|constricted]] during the aura phase and [[Vasodilation|dilated]] during the pain phase, so a constrictive medication like a triptan is not recommended during the aura.<ref>{{Cite journal |last2= Elliott|first2= D.|date=June 6, 2007 |title=Acute migraine: Current treatment and emerging therapies |journal=Therapeutics and Clinical Risk Management |volume=3 |issue=3 |pages=449–459 |issn=1176-6336 |pmc=2386351 |pmid=18488069|last1= Kalra|first1= A. A.}}</ref>

===Cluster headache===
Triptans are effective for the treatment of [[cluster headache]]. This has been demonstrated for [[Subcutaneous injection|subcutaneous]] sumatriptan and [[intranasal]] zolmitriptan, the former of which is more effective according to a 2013 [[Cochrane review]]. Tablets were not considered appropriate in this review.<ref>{{cite journal|title=Triptans for acute cluster headache|journal=The Cochrane Database of Systematic Reviews|volume=7|issue=7|pages=CD008042|pmid=24353996|doi=10.1002/14651858.CD008042.pub3|year=2013|last1=Law|first1=S|last2=Derry|first2=S|last3=Moore|first3=R. A.|pmc=4170909}}</ref>

===Altitude sickness===
A single [[randomized controlled trial]] found that sumatriptan may be able to prevent [[altitude sickness]].<ref name="pmid17557349">{{cite journal |vauthors=Jafarian S, Gorouhi F, Salimi S, Lotfi J |title=Sumatriptan for prevention of acute mountain sickness: randomized clinical trial |journal=Ann. Neurol. |volume=62 |issue=3 |pages=273–7 |year=2007 |pmid=17557349 |doi=10.1002/ana.21162|s2cid=7799716 }}</ref>

===Available forms===
All marketed triptans are available in [[oral administration|oral]] form; some in form of [[sublingual]] tablets.<ref name="AC">{{cite book|title=Austria-Codex|at=Zomig Rapimelt; Maxalt Rapitab|editor=Haberfeld, H|publisher=Österreichischer Apothekerverlag|location=Vienna|year=2016|language=de}}</ref> Sumatriptan and zolmitriptan are also available as [[nasal spray]]s.<ref name="AC" /><ref>{{Cite web|url=https://www.gsksource.com/pharma/content/dam/GlaxoSmithKline/US/en/Prescribing_Information/Imitrex_Nasal_Spray/pdf/IMITREX-NASAL-SPRAY-PI-PIL.PDF|title=Imitrex Nasal Spray package insert|website=GlaxoSmithKline prescribing information|access-date=May 20, 2016|url-status=live|archive-url=https://web.archive.org/web/20150905173656/https://www.gsksource.com/pharma/content/dam/GlaxoSmithKline/US/en/Prescribing_Information/Imitrex_Nasal_Spray/pdf/IMITREX-NASAL-SPRAY-PI-PIL.PDF|archive-date=September 5, 2015}}</ref> For sumatriptan, a number of other application forms are marketed: [[suppositories]], a subcutaneous injection,<ref name="AC" /> an [[iontophoretic]] transdermal patch, which uses low voltage controlled by a pre-programmed microchip to deliver a single dose of sumatriptan through the skin within 30 minutes;<ref name=":0">{{Cite journal|last1=Pierce|first1=Mark|last2=Marbury|first2=Thomas|last3=O'Neill|first3=Carol|last4=Siegel|first4=Steven|last5=Du|first5=Wei|last6=Sebree|first6=Terri|date=2009-06-01|title=Zelrix: a novel transdermal formulation of sumatriptan|journal=Headache|volume=49|issue=6|pages=817–825|doi=10.1111/j.1526-4610.2009.01437.x|issn=1526-4610|pmid=19438727|doi-access=free}}</ref> a drug-device combination containing sumatriptan powder that is "breath powered" allowing the user to blow sumatriptan powder in to their nostrils;<ref>{{Cite web|url=https://www.pharmacytimes.com/news/onzetra-xsail-approved-as-migraine-treatment|title=Onzetra Xsail Approved as Migraine Treatment|date=February 3, 2016|website=pharmacytimes.com|access-date=October 1, 2019}}</ref> as well as a needle-free injection system that works with air pressure.<ref name="Zogenix" />
{| class="wikitable"
|+Formulations<ref>{{Cite journal|last=Gladstone|first=Jonathan|title=Newer formulations of the triptans: advances in migraine management|journal=Drugs|year=2003 |volume=63|issue=21 |pages=2285–2505|doi=10.2165/00003495-200363210-00002 |pmid=14524731 |s2cid=46971222 |via=2305}}</ref>
!Tablet
!Oral disintegrating tablets
!Nasal spray
!Subcutaneous injection
!Rectal suppository
|-
|all triptans
|rizatriptan
|sumatriptan
|sumatriptan
|sumatriptan
|-
|
|zolmitriptan
|zolmitriptan
|
|
|}